An integrated model for guiding the selection of treatment components for problem behavior maintained by automatic reinforcement.

We evaluated the usefulness of 2 assessments to guide treatment selection for individuals whose prior functional analysis indicated that automatic reinforcement maintained their problem behavior. In the 1st assessment, we compared levels of problem behavior during a noncontingent play condition and an alone or ignore condition. In the 2nd, we assessed participants' relative preferences for automatic reinforcement and social reinforcers in a concurrent-operants arrangement. We used the results of these 2 assessments to assign 5 participants to a treatment based on noncontingent access to social reinforcers or to a treatment based on differential access to social reinforcers. We conducted monthly probes with the participants over 10 to 12 months to evaluate the effects of the treatment procedures. All participants showed reductions in problem behavior over this period.

Indirect Effects of Functional Communication Training on Non-Targeted Disruptive Behavior.

The purpose of this study was to evaluate the effects of functional communication training (FCT) on the occurrence of non-targeted disruptive behavior. The 10 participants were preschool-aged children with developmental disabilities who engaged in both destructive (property destruction, aggression, self-injury) and disruptive (hand flapping, spinning in circles, shrill laughter, screaming, crying) behaviors. Only destructive behavior was targeted for the functional analyses and FCT, but data were also collected on disruptive behaviors. All procedures were conducted in the participants' homes by their mothers with investigator coaching. Phase 1 consisted of conducting a functional analysis within a multielement design. Phase 2 consisted of conducting FCT with demand fading and repeated extinction baselines within a reversal design. Single-case data are provided for 3 participants, and summary data are provided for all 10 participants. Results of phase 1 showed that all participants' destructive and disruptive behavior was maintained, at least in part, by negative reinforcement. Results of phase 2 showed that both destructive behavior and non-targeted disruptive behavior occurred at lower levels during FCT when compared to the functional analysis demand condition and baseline conditions, suggesting that FCT was effective in decreasing both target destructive behavior and non-targeted disruptive behaviors.

Is air-displacement plethysmography a reliable method of detecting ongoing changes in percent body fat within obese children involved in a weight management program?

BACKGROUND: The prevalence of childhood obesity in the US has increased considerably over the last few decades and continues to increase. To monitor the progress of patients enrolled in weight management programs, clinicians need accurate methods of detecting changes in body composition (percent body fat) over time. The gold standard method, hydrodensitometry, has severe limitations for the pediatric population. OBJECTIVE: This study examines the reliability of air-displacement plethysmography (ADP) in detecting percent body fat changes within obese children over time. METHODS: Percent body fat by ADP, weight, and body mass index (BMI) were measured for eight obese children aged 5-12 years enrolled in a weight management program over a 12-month period. These measurements were taken at initial evaluation, 1.5 months, 3 months, 6 months, and 12 months to monitor the progress of the subjects and detect any changes in these measures over time. Statistical analysis was used to determine the reliability of the data collected. RESULTS: The reliability estimate for percent body fat by ADP was 0.78. This was much lower than the reliability of BMI, 0.98, and weight measurements, 0.99. The low reliability estimate of ADP indicates a large standard error of measurement by this method. CONCLUSION: The measurement error of ADP is large, and in our study, ADP measured changes in percent body fat that far exceeded levels of true change that would have been clinically useful and important to detect. Hence, this method yielded change measures that did not allow meaningful clinical interpretations and often did not reflect true differences in status across time. ADP is not a reliable method for detecting changes in percent body fat over the time intervals employed within this study of obese children.

Assessment and treatment of aggressive behavior without a clear social function.

We conducted functional analyses of two individuals' aggressive behavior. Results of each of the initial functional analyses were inconclusive with respect to the role of social reinforcers in the maintenance of the behavior. Further assessment was conducted to clarify the role of social reinforcers. One individual's results suggested social reinforcers were relevant while results for the second individual remained inconclusive. Treatment evaluations conducted with both individuals suggested manipulation of social consequences could be used to reduce aggressive behavior even though, in one case, no clear social function was apparent.